0
Mappings
0
Definitions
0
Inheritance
5
Pathophysiology
0
Histopathology
4
Phenotypes
10
Pathograph
0
Genes
2
Treatments
0
Subtypes
2
Differentials
1
Datasets
1
Trials
0
Models
1
Literature

Pathophysiology

5
Dysregulated cerebrospinal fluid dynamics
The central pathophysiologic problem in IIH is dysregulation of CSF dynamics, leading to persistently elevated intracranial pressure in the absence of a mass lesion.
choroid plexus epithelial cell link
cerebrospinal fluid secretion link ⚠ ABNORMAL
Show evidence (1 reference)
PMID:34929642 SUPPORT Other
"The pathophysiology involves dysregulation of cerebrospinal fluid (CSF) dynamics and venous sinus pressure"
This directly supports dysregulated CSF dynamics as the core mechanism.
Elevated intracranial pressure
Persistently elevated intracranial pressure causes the characteristic neuro-ophthalmologic and headache syndrome of pseudotumor cerebri.
Show evidence (1 reference)
PMID:38575259 SUPPORT Other
"Pseudotumor cerebri syndrome is a syndrome of increased cerebrospinal fluid pressure without ventriculomegaly, mass lesion, or meningeal abnormality."
This directly supports elevated CSF pressure as the defining proximal abnormality.
Metabolic risk background
IIH strongly favors obese women of reproductive age, and metabolic and hormonal factors are thought to amplify CSF and venous-pressure dysregulation.
Show evidence (1 reference)
PMID:34929642 SUPPORT Other
"IIH demonstrates a strong predilection towards obese women of reproductive age"
This supports the major metabolic-epidemiologic background on which IIH develops.
Papilledema and visual injury
Elevated intracranial pressure leads to papilledema and threatens permanent visual loss if not recognized and treated.
Show evidence (1 reference)
PMID:38575259 SUPPORT Other
"Permanent visual loss occurs if undetected or untreated"
This directly supports the optic-nerve/vision branch of the disease mechanism.
Headache syndrome
Headache is the predominant symptomatic morbidity of pseudotumor cerebri and reflects the elevated-pressure state.
Show evidence (1 reference)
PMID:35103000 SUPPORT Other
"headache is the predominant morbidity in over 90%."
This directly supports headache as the dominant symptomatic output of the pressure syndrome.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for pseudotumor cerebri Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.

Phenotypes

4
Ear 1
Pulsatile tinnitus Pulsatile tinnitus (HP:0008629)
Show evidence (1 reference)
PMID:34929642 SUPPORT Other
"The primary symptoms include headache, vision loss, and pulsatile tinnitus"
This directly supports pulsatile tinnitus as a primary symptom.
Eye 2
Papilledema Papilledema (HP:0001085)
Show evidence (1 reference)
PMID:34929642 SUPPORT Other
"Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure, manifested by papilledema"
This directly supports papilledema as a defining sign.
Visual loss FREQUENT Visual loss (HP:0000572)
Show evidence (2 references)
PMID:34929642 SUPPORT Other
"The primary symptoms include headache, vision loss, and pulsatile tinnitus"
This directly supports visual loss as a primary symptom.
clinicaltrials:NCT01003639 SUPPORT Human Clinical
"Because of pressure on the optic nerve (papilledema), 86% have some degree of permanent visual loss and 10% develop severe visual loss"
This quantitative trial summary supports visual loss as a frequent phenotype in pseudotumor cerebri.
Nervous System 1
Headache Headache (HP:0002315)
Show evidence (1 reference)
PMID:34929642 SUPPORT Other
"The primary symptoms include headache, vision loss, and pulsatile tinnitus"
This directly supports headache as a primary symptom.
💊

Treatments

2
Acetazolamide
Action: pharmacotherapy MAXO:0000058
Agent: acetazolamide
Acetazolamide is the best-studied medical therapy and improves visual outcomes when combined with a weight-reduction program in patients with mild visual loss.
Target Phenotypes: Papilledema Visual loss
Show evidence (1 reference)
PMID:24756514 SUPPORT Human Clinical
"In patients with IIH and mild visual loss, the use of acetazolamide with a low-sodium weight-reduction diet compared with diet alone resulted in modest improvement in visual field function."
This randomized trial directly supports acetazolamide as disease-relevant therapy.
Weight-reduction intervention
Action: dietary intervention MAXO:0000088
Weight reduction is a core disease-directed intervention in overweight patients with IIH.
Target Phenotypes: Headache Papilledema
Show evidence (1 reference)
PMID:34929642 SUPPORT Other
"The Idiopathic Intracranial Hypertension Treatment Trial, the first of its kind randomized controlled trial on IIH, provides class I evidence for treatment with weight loss and acetazolamide."
This directly supports weight loss as a disease-directed intervention.
🔀

Differential Diagnoses

2

Conditions with similar clinical presentations that must be differentiated from pseudotumor cerebri:

Cerebral sinovenous thrombosis Not Yet Curated MONDO:0017993
Overlapping Features Venous sinus thrombosis can mimic IIH with papilledema and raised intracranial pressure and must be excluded on imaging.
Show evidence (1 reference)
PMID:39525793 SUPPORT Human Clinical
"Common causes of headaches during puerperium include pre-eclampsia, subarachnoid hemorrhage, cerebral venous thrombosis, meningitis, brain tumors, cerebrovascular diseases, and posterior reversible encephalopathy syndrome."
This directly identifies cerebral venous thrombosis as an important competing diagnosis in patients presenting with pseudotumor-cerebri-like headache and visual symptoms.
Brain neoplasm Not Yet Curated MONDO:0021211
Overlapping Features Intracranial mass lesions must be excluded before the diagnosis of pseudotumor cerebri is made.
Show evidence (1 reference)
PMID:12455560 SUPPORT Other
"The syndrome of increased intracranial pressure without hydrocephalus or mass lesion and with normal CSF composition, previously referred to as pseudotumor cerebri, is a diagnosis of exclusion now termed idiopathic intracranial hypertension (IIH)."
This directly supports exclusion of mass lesions such as brain neoplasms when diagnosing pseudotumor cerebri.
📊

Related Datasets

1
Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial. PMID:24756514
Multicenter randomized controlled trial dataset capturing visual fields, papilledema grading, weight change, and headache-related outcomes in IIH.
Homo sapiens n=165
Conditions: idiopathic intracranial hypertension mild visual loss
PMID:24756514
Show evidence (1 reference)
PMID:24756514 SUPPORT Human Clinical
"Multicenter, randomized, double-masked, placebo-controlled study of acetazolamide in 165 participants with IIH and mild visual loss"
This supports the study as a reusable human interventional dataset for IIH.
🔬

Clinical Trials

1
NCT01003639 PHASE_III COMPLETED
Randomized placebo-controlled IIHTT trial testing acetazolamide plus low-sodium weight-reduction diet in patients with mild visual loss.
Target Phenotypes: Visual loss Papilledema
Show evidence (1 reference)
clinicaltrials:NCT01003639 SUPPORT Human Clinical
"This trial will study subjects who have mild visual loss from IIH to (1) establish convincing, evidence-based treatment strategies for IIH to restore and protect vision, (2) follow subjects up to 4 years to observe the long-term treatment outcomes and (3) determine the cause of IIH."
The registered IIHTT trial directly targeted visual outcomes in IIH.
📚

Literature Summaries

1
Asta
Asta Literature Retrieval: Pathophysiology and clinical mechanisms of pseudotumor cerebri. Core disease mechanisms, molecular and cellular pathw...
Asta Scientific Corpus Retrieval 20 citations 2026-04-13T13:54:04.205511

Asta Literature Retrieval: Pathophysiology and clinical mechanisms of pseudotumor cerebri. Core disease mechanisms, molecular and cellular pathw...

This report is retrieval-only and is generated directly from Asta results.

  • Papers retrieved: 20
  • Snippets retrieved: 20

Relevant Papers

[1] Changes in Serum Proteomic Profiles at Different Stages of Pregnancy Toxemia in Goats

  • Authors: M. Uzti̇mür, C. N. Ünal, Gurler Akpinar
  • Year: 2025
  • Venue: Journal of Veterinary Internal Medicine
  • URL: https://www.semanticscholar.org/paper/4b9c488b5dbd65d7b26fd2ad9aed70e8c4b59942
  • DOI: 10.1111/jvim.70139
  • PMID: 40492724
  • PMCID: 12150350
  • Summary: Understanding the serum proteome profiles of goats with pregnancy toxemia might help identify the proteomes and pathways responsible for the development of this disease and improve diagnosis and treatment.
  • Evidence snippets:
  • Snippet 1 (score: 0.364) > The pathophysiology and progression of this disease are not fully understood. > Traditional biomedical research has focused on the analysis of single genes, proteins, metabolites, or metabolic pathways in diseases. This molecular reductionist approach is based on the assumption that identifying genetic variations and molecular components will lead to new treatments for diseases [13][14][15][16]. However, many diseases are complex and multifactorial, and in order to determine the phenotype of such diseases, it is necessary to understand the changes that occur in more than one gene, pathway, protein, or metabolite at the cellular, tissue, and organismal levels [17][18][19]. Therefore, in recent years, proteomics, as one field of multi-omics technologies, has helped in evaluating the complex pathogenetic mechanisms of different diseases from a broad perspective and has made substantial contributions [20,21]. In veterinary medicine, proteomic analysis of metabolic diseases such as ketosis [16], hypocalcemia [22], and fatty liver [23] in dairy cows has contributed valuable insights for the definition of new pathophysiological pathways and new diagnosis and treatment protocols for these diseases. The proteomic approach can contribute importantly to a broad and detailed understanding of the changes that occur at the organismal level associated with the increase in BHBA concentration in goats with pregnancy toxemia. Our aim was to evaluate the serum protein profiles of goats with SPT or CPT using proteomic techniques to determine the proteomic profiles of these animals and to identify the relevant pathophysiological mechanisms.

[2] Molecular Mechanisms and Risk Factors for the Pathogenesis of Hydrocephalus

  • Authors: Jing-wen Li, Xinjie Zhang, Jianfeng Guo, Chen Yu, Jun Yang
  • Year: 2022
  • Venue: Frontiers in Genetics
  • URL: https://www.semanticscholar.org/paper/d53bdf5f73f54a6d5a8be8777d23c465a13e9185
  • DOI: 10.3389/fgene.2021.777926
  • PMID: 35047005
  • PMCID: 8762052
  • Citations: 15
  • Influential citations: 2
  • Summary: Some possible fundamental molecular mechanisms and facilitating risk factors involved in the pathogenesis of hydrocephalus are elicited, and knowledge could be used to improve patient care in different ways, such as early precise diagnosis and effective therapeutic regimens.
  • Evidence snippets:
  • Snippet 1 (score: 0.361) > Cwh43 modifies the glycosylphosphatidylinositol-anchored proteins on the ependymal cells, and the mutant Cwh43 is related to iNPH in both humans and mice. The clinical features manifest as late-onset communicating hydrocephalus with symptoms of gait and balance dysfunction (Yang et al., 2021a). > The clinical manifestation and progression, as well as experimental investigations, indicate that hydrocephalus is a complex disease with polygenic involvement, rather than a simple CSF accumulation disorder. Although the current studies have revealed that some genetic mutations are involved in the pathogenesis of hydrocephalus, how these mutations are associated with the disorder of CSF circulation and their pathogenic roles in the pathological progression of hydrocephalus still remain largely unknown. Previous studies indicated that a lot of genetic mutations were relevant to the disorders of ciliary and/or centrosome, resulting in the dysfunction of the glymphatic system. However, how these mutations and their interactions contribute to the pathogenesis of hydrocephalus needs to be further elucidated. Moreover, there is still a lack of basic knowledge on the mechanisms underlying the cognitive functional impairment of hydrocephalus. Therefore, further extensive studies should be conducted to explore the underlying molecular mechanisms of identified and/or unidentified genes in the pathophysiology of hydrocephalus. Based on our knowledge, we propose that the genetic mutations relevant to ciliary and centrosomal proteins and the interaction between glymphatic system and ciliary/ centrosomal structures/functions may be a critical molecular mechanism in the pathophysiology of hydrocephalus. In addition, based on these fundamental molecular mechanisms, it is noteworthy that environmental and other acquired risks or etiological factors are also involved in the facilitation of ventricular enlargement.

[3] Molecular and cellular characteristics of cerebrovascular cell types and their contribution to neurodegenerative diseases

  • Authors: F. J. García, Myriam Heiman
  • Year: 2025
  • Venue: Molecular Neurodegeneration
  • URL: https://www.semanticscholar.org/paper/651ecb2269ae562236345f2451cab13e3d495216
  • DOI: 10.1186/s13024-025-00799-z
  • PMID: 39881338
  • PMCID: 11780804
  • Citations: 6
  • Summary: The current understanding of cerebrovasculature structure, function, and cell type diversity and its role in the mechanisms underlying various neurodegenerative diseases is described.
  • Evidence snippets:
  • Snippet 1 (score: 0.356) > Aging-associated neurodegenerative diseases exhibit distinct patterns of enhanced vulnerability, whereby specific populations of neurons are earliest and most affected in each disease [1]. Disease symptoms and progression, in turn, reflect the dysfunction of these most vulnerable cell types and associated circuits. In many cases, it is not into the molecular basis underlying cell structure and function [4][5][6][7]. Furthermore, single cell studies of specific neurodegenerative diseases have focused on profiling cells in the affected brain regions to understand cell type-specific dysregulation with the potential of uncovering disease-relevant gene expression patterns that could lead into the development of novel therapeutic strategies [8][9][10][11][12]. These studies have highlighted the interplay between affected neurons and other cell types of the brain, especially with identification of disease-associated genes that are enriched in non-neuronal cell populations, such as microglia and cerebrovascular cell types [13,14]. > In recent years, the cerebrovasculature and its role in the pathophysiology of neurodegenerative diseases has become a topic of considerable research focus. Despite extensive clinical data documenting functional changes in cerebrovascular function, especially at early stages of disease, the precise cellular and molecular mechanisms underlying these changes, particularly in humans, are not fully understood. Common themes of cerebrovasculature dysfunction, such as aberrant angiogenesis, decreases in tight junction expression, and increased transcytosis, have been noted, but the exact contributions of specific cerebrovascular cell types, and more importantly, their causal contribution to disease mechanisms are unknown. However, with the advent of a single cell atlas of the mouse cerebrovasculature, a framework for studying the molecular profiles of cerebrovascular cell types has been recently established [15]. This work provided a reference for several subsequent human atlases and the corresponding molecular changes within these cell types that occur across development and disease [14,[16][17][18][19][20]. > This review focuses on our current understanding of cerebrovasculature structure and function and its role in neurodegenerative diseases.

[4] Organoids in gastrointestinal diseases: from bench to clinic

  • Authors: Qinying Wang, Fanying Guo, Qinyuan Zhang, Tingting Hu, Yutao Jin et al.
  • Year: 2024
  • Venue: MedComm
  • URL: https://www.semanticscholar.org/paper/9b8880d8b9d45670da950197d7e353794f51d09e
  • DOI: 10.1002/mco2.574
  • PMID: 38948115
  • PMCID: 11214594
  • Citations: 12
  • Summary: A comprehensive and systematical depiction of organoids models is drawn, providing a novel insight into the utilization of organoids models from bench to clinic and clinical adhibition.
  • Evidence snippets:
  • Snippet 1 (score: 0.354) > Organoids models offer a robust platform for investigating the potential mechanisms of GI diseases and evaluating potential therapeutic interventions.By culturing organoids derived from patients' tissues or stem cells, researchers can delve into disease-specific cellular and molecular pathways, encompassing aberrant cell signaling, perturbed immune responses, and dysfunctional metabolic processes.These disease-specific phenotypes enable the study of disease progression, screening of prospective therapeutics, as well as identification of novel drug targets and mechanisms of action for GI diseases in a clinically relevant context.

[5] Recent advances in modelling of cerebellar ataxia using induced pluripotent stem cells

  • Authors: M. M. Wong, L. Watson, Esther B. E. Becker
  • Year: 2017
  • Venue: Journal of neurology & neuromedicine
  • URL: https://www.semanticscholar.org/paper/0d962652305116e383ab260b9e82d3a5ffe1722f
  • DOI: 10.29245/2572.942X/2017/7.1134
  • PMID: 28825058
  • PMCID: 5558869
  • Citations: 9
  • Summary: This review focuses on recent breakthroughs in generating human iPSC-derived Purkinje cells and highlights the future challenges that will need to be addressed in order to fully exploit these models for the modelling of the molecular mechanisms underlying cerebellar ataxias and the development of effective therapeutics.
  • Evidence snippets:
  • Snippet 1 (score: 0.353) > dominant polyglutamine spinocerebellar ataxias (SCAs) are the most studied forms of ataxias. Despite significant clinical and genetic heterogeneity, emerging evidence points to the existence of common pathogenic mechanisms that may be shared by several genetically distinct forms of cerebellar ataxias (reviewed in5-8). However, it is still unclear how the proposed pathological pathways ultimately result in cerebellar dysfunction and degeneration, predominantly affecting Purkinje cells. > Understanding disease mechanisms is key to treating neurodegenerative disorders. The heterogeneous nature of the cerebellar ataxias combined with the unavailability of human brain tissue and the lack of reliable disease models have, however, hampered our understanding of the molecular disease mechanisms underlying cerebellar ataxias and thus, the development of effective therapies. Although mouse models of several cerebellar ataxias, including FRDA and SCAs, have provided valuable insights into the pathophysiology of these disorders (reviewed in9), many questions remain about the observed species differences in disease phenotypes and the effectiveness of potential drugs in clinical trials. > To help translate research from animal models into novel treatments for ataxia patients, it is essential to validate findings in the relevant affected human cell types, particularly in cerebellar Purkinje cells. The current obstacles might be overcome by exploiting recently developed human induced pluripotent stem cell (iPSC) technology and neuronal differentiation protocols.

[6] New therapeutic targets in rare genetic skeletal diseases

  • Authors: M. Briggs, Peter A. Bell, M. Wright, K. A. Pirog
  • Year: 2015
  • Venue: Expert Opinion on Orphan Drugs
  • URL: https://www.semanticscholar.org/paper/1363107f71ae6d2d60abca471cddf3da5d13644b
  • DOI: 10.1517/21678707.2015.1083853
  • PMID: 26635999
  • PMCID: 4643203
  • Citations: 37
  • Influential citations: 1
  • Summary: An overview of disease mechanisms that are shared amongst groups of different GSDs and potential therapeutic approaches that are under investigation are described to generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.
  • Evidence snippets:
  • Snippet 1 (score: 0.352) > proteins of the cartilage ECM such as type II collagen [50]. However, emerging knowledge suggests that the primary genetic defect may be less important than the cells' response to the expression of the mutant gene product [107]. Moreover, the largely overlooked response of a cell (i.e. chondrocyte) to the abnormal extracellular environment is also important for disease progression as illustrated by several GSDs discussed in this review. > It is important that 'omics'-based approaches and technologies are systematically applied to the study of rare GSDs so that definitive reference profiles and disease signatures are generated for each phenotype. These can then be used in a Systems Biology approach to identify both common and dissimilar pathological signatures and disease mechanisms. This approach is entirely dependent upon relevant in vitro and in vivo models (and also novel 'disease-mechanism phenocopies' [107]) for testing new diagnostic and prognostic tools and for determining the molecular mechanisms that underpin the pathophysiology so that effective therapeutic treatments can be developed and validated. This approach will eventually lead to personalized treatments and care strategies centred on shared disease mechanisms with the use of relevant biomarkers to monitor the efficacy of treatment and disease progression. > It is vital that all relevant stakeholders are involved from the outset in defining the appropriate outcomes of any potential therapeutic regime. The perceptions of a successful therapy can differ widely between the clinical academic community and the relevant patient-support groups and it is vital that there is engagement on all these issues. > In summary, the identification of causative genes and mutations for GSDs over the last 20 years, coupled with the generation and in-depth analysis of a plethora of relevant cell and mouse models, has derived new knowledge on disease mechanisms and suggested potential therapeutic targets. The fast-evolving hypothesis that clinically disparate diseases can share common disease mechanisms is a powerful concept that will generate critical mass for the identification and validation of novel therapeutic targets and biomarkers.

[7] Nasopharyngeal Carcinoma Signaling Pathway: An Update on Molecular Biomarkers

  • Authors: W. Tulalamba, T. Janvilisri
  • Year: 2012
  • Venue: International Journal of Cell Biology
  • URL: https://www.semanticscholar.org/paper/307cb9186444d9dad6e2e3b53763be0de76de186
  • DOI: 10.1155/2012/594681
  • PMID: 22500174
  • PMCID: 3303613
  • Citations: 93
  • Influential citations: 5
  • Summary: The molecular signaling pathways in the NPC are discussed for the holistic view of NPC development and progression and the important insights toward NPC pathogenesis may offer strategies for identification of novel biomarkers for diagnosis and prognosis.
  • Evidence snippets:
  • Snippet 1 (score: 0.351) > In the pregenomic eras, highly integrated and complex circuitry of molecular signaling in NPC pathogenesis was only partially understood. Over the past decade, the knowledge of the molecular mechanisms in NPC carcinogenesis has been rapidly accumulated. Dysregulation and abnormal protein expression of molecules in certain signaling pathways involved in cellular functions including proliferation, adhesion, survival, and apoptosis has been demonstrated in the NPC cells. Detailed information on the complex network in signaling pathway leading to a coordinated pattern of gene expression and regulation in NPC will undoubtedly provide important clues to develop novel prognostic and therapeutic strategies for this cancer. Refining molecular markers into clinically relevant assays may assist in the detection of NPC in asymptomatic patients, as well as stage classification and monitoring disease progression and treatments. Furthermore, selective regulation of particular proteins targeting cancer cell proliferation, invasion, and apoptosis is a hopeful prospect for future anticancer therapy that slow disease progression and improve survival.

[8] Human Dermal Fibroblast: A Promising Cellular Model to Study Biological Mechanisms of Major Depression and Antidepressant Drug Response

  • Authors: P. Mesdom, R. Colle, É. Lebigot, S. Trabado, Eric Deflesselle et al.
  • Year: 2020
  • Venue: Current Neuropharmacology
  • URL: https://www.semanticscholar.org/paper/79368e365458486de96794333613c12a6063bf54
  • DOI: 10.2174/1570159X17666191021141057
  • PMID: 31631822
  • PMCID: 7327943
  • Citations: 12
  • Summary: This review highlights the great and still underused potential of HDF, which stands out as a very promising tool in the understanding of MDD and AD mechanisms of action.
  • Evidence snippets:
  • Snippet 1 (score: 0.346) > Background: Human dermal fibroblasts (HDF) can be used as a cellular model relatively easily and without genetic engineering. Therefore, HDF represent an interesting tool to study several human diseases including psychiatric disorders. Despite major depressive disorder (MDD) being the second cause of disability in the world, the efficacy of antidepressant drug (AD) treatment is not sufficient and the underlying mechanisms of MDD and the mechanisms of action of AD are poorly understood. Objective The aim of this review is to highlight the potential of HDF in the study of cellular mechanisms involved in MDD pathophysiology and in the action of AD response. Methods The first part is a systematic review following PRISMA guidelines on the use of HDF in MDD research. The second part reports the mechanisms and molecules both present in HDF and relevant regarding MDD pathophysiology and AD mechanisms of action. Results HDFs from MDD patients have been investigated in a relatively small number of works and most of them focused on the adrenergic pathway and metabolism-related gene expression as compared to HDF from healthy controls. The second part listed an important number of papers demonstrating the presence of many molecular processes in HDF, involved in MDD and AD mechanisms of action. Conclusion The imbalance in the number of papers between the two parts highlights the great and still underused potential of HDF, which stands out as a very promising tool in our understanding of MDD and AD mechanisms of action

[9] Modeling psychiatric disorders: from genomic findings to cellular phenotypes

  • Authors: Anna Falk, Vivi M. Heine, A. Harwood, Patrick F. Sullivan, M. Peitz et al.
  • Year: 2016
  • Venue: Molecular Psychiatry
  • URL: https://www.semanticscholar.org/paper/235b41240d78140de7ab06a3ad8a7d0b1bdff1a5
  • DOI: 10.1038/mp.2016.89
  • PMID: 27240529
  • PMCID: 4995546
  • Citations: 77
  • Influential citations: 2
  • Summary: The challenges for modeling of psychiatric disorders, potential solutions and how iPSC technology can be used to develop an analytical framework for the evaluation and therapeutic manipulation of fundamental disease processes are critically reviewed.
  • Evidence snippets:
  • Snippet 1 (score: 0.337) > The key challenge for iPSC-based disease modeling is to identify one or more relevant cellular phenotypes that accurately represent the disease pathophysiology. Increasing numbers of reports have demonstrated that for many diseases specific pathophysiology can be captured in human iPSC-based disease models. These range from cardiovascular disease, 44,45 cancer, 46,47 ocular disease, 48,49 diabetes mellitus 50,51 and neurological disorders of the brain. 52,53 Can the same approach be applied to complex psychiatric disorders? > The problem is that almost all psychiatric disorders are characterized by clinical signs and symptoms, but lack independent verification from objective biomarkers. Thus, how might these clinical phenotypes manifest themselves in terms of cell behavior? The identity of robust cellular 'readouts', which typify any psychiatric disorder, is a crucial unsolved problem and an area of intense study 54 (Table 2). When satisfactorily answered, this will herald a new degree of biological objectivity and quantification for the study of psychiatric disorders. > The aim is to find a single or small number of cell phenotypes or parameters that strongly associate with psychiatric disorders, and establish a cellular profile characteristic of cells derived from the general patient population. Although a consensus set of cellular phenotypes for psychiatric disorder is yet to be established, we can define some of their desired characteristics. First, cellular phenotypes have to relate to the biological pathways identified by genetics. Second, although there are many risk genes in disparate biological pathways, at some level, phenotypes should converge onto a much smaller grouping. Third, phenotypes need to be quantifiable. Finally, to be useful for drug development cellular phenotypes should be reversed by pharmacological treatment, although not necessarily by drugs in current use. > Although human iPSC-based approaches underrepresent the complexity of the human central nervous system, cellular phenotypes are likely to lie more proximal to molecular disease mechanisms than phenotypes seen at the level of a tissue or organism, 55 and thus may bypass compensatory homeostatic (2) Gene expression profiles of SCZ human iPSC neurons identified altered expression of many components of the cyclic AMP and WNT signaling pathways. > (3

[10] Recent Evidences of Epigenetic Alterations in Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review

  • Authors: R. Ragusa, Pasquale Bufano, A. Tognetti, M. Laurino, Chiara Caselli
  • Year: 2025
  • Venue: International Journal of Molecular Sciences
  • URL: https://www.semanticscholar.org/paper/2660cdbbe1f205c631fe890e5c6a3c8d9b81ce5f
  • DOI: 10.3390/ijms26062571
  • PMID: 40141213
  • PMCID: 11942187
  • Citations: 4
  • Summary: A systematic review of the latest knowledge on epigenetic modifications that characterize COPD, summarizing epigenetic factors that could serve as potential novel biomarkers and therapeutic targets for the treatment of COPD patients.
  • Evidence snippets:
  • Snippet 1 (score: 0.336) > The papers included were clustered according to epigenetic mechanisms involved in COPD (molecular and cellular processes, as biomarker or therapeutic target). Tables 4-9 describe the extracted information, including the following: Study = name of first author et al., year; Country (Region) = where the study took place; Number of participants = sample size; Type of sample = biological sample employed; Gene affected = gene or group of genes whose expression can be "regulated" by epigenetic mechanisms; Epigenetic alteration = type of epigenetic alteration observed in the presence of disease; Activity in COPD = involvement of epigenetic elements in different molecular and cellular mechanisms associated with COPD; and Role of epigenetic mechanisms = epigenetic modifications that can be used to explain the pathophysiology of COPD or as biomarkers and therapeutic targets.

[11] Chemotherapy and Mechanisms of Resistance in Breast Cancer

  • Authors: A. Oliveira, R. E. Santos, F. F. O. Rodrigues
  • Year: 2012
  • Venue: Unknown venue
  • URL: https://www.semanticscholar.org/paper/502a86d8bcd7208be6f539fcceba631f82f25a7d
  • DOI: 10.5772/24629
  • Summary: The addition of adjuvant polychemotherapy in advanced breast cancer showed gain by controlling survival of micrometastases in patients with lymph nodes affected by cancer or not.
  • Evidence snippets:
  • Snippet 1 (score: 0.336) > The main reasons responsible for treatment failure in cancer patients are the mechanisms of drug resistance and emergence of disseminated disease (Terek et al, 2003). We identified two types of resistance most relevant to BC: primary resistance, which corresponds to the clinical situation where the patient showed no response to therapy, and secondary or acquired resistance in which, initially, there is an observed response and a subsequent failure of the treatment regimen (Kroger et al, 1999). Several mechanisms may cause the phenotype of multidrug resistance to chemotherapy drugs and are well characterized in in vitro experiments, including alterations in systemic pharmacology (pharmacokinetics and metabolism), extracellular mechanisms (tumor environment, multicellular drug resistance), and cellular mechanisms (cellular pharmacology, activation and inactivation of drugs, modification of specific targets and regulatory pathways of apoptosis) (Leonessa et al, 2003, Riddick et al, 2005. Identification of factors that affect cell metabolism, which are related to drug resistance, will enable the identification of which patients are at particular risk of treatment failure. Among the biochemical and molecular mechanisms of drug resistance, we stress: changes in the activity of topoisomerase II, alterations in the DNA repair mechanism, overexpression of P-glycoprotein; high intracellular concentrations of enzymes purification of cellular metabolism -among them enzymes the family of glutathione S-transferases (GSTs) and changes in the mechanisms of signaling via c-Jun N-terminal kinase 1 (JNK1) -and "apoptosis signal-regulating kinase (ASK1) required for activation of the" mitogenactivated protein (MAP kinases) in apoptosis and cellular restoration. These pathways are also mediated by proteins encoded by genes of GSTs (O'Brien, Tew, 1996;Burg, Mulder, 2002, L'Ecuyer et al, 2004). Different response rates to particular chemotherapy regimens, as observed in patient groups with the same biological characteristics and stage, suggest the existence of different mechanisms of drug resistance, probably induced by genetic alterations (Hayes, Pulford, 1995;O'Brien , Tew, 1996;Pakunlu et al, 2003). Among the mechanisms of purification of cellular metabolism involved in the

[12] Role of Transcriptomics in Precision Oncology

  • Authors: Ruby Srivastava
  • Year: 2024
  • Venue: Reports of Radiotherapy and Oncology
  • URL: https://www.semanticscholar.org/paper/0bd862558bbb7286336111d9dfd232b5f905d3d9
  • DOI: 10.5812/rro-142195
  • Citations: 4
  • Summary: : Transcriptome profiling is one of the most widely used approaches in the field of multiomics research. It plays a crucial role in the prognostic, diagnostic, and predictive treatment of cancer patients. Novel next-generation sequencing (NGS) technologies permit the identification of cancer biomarkers, gene signatures, and their abnormal expression, affecting oncogenic and molecular targets and novel biomarkers for cancer therapies. Multiomics studies have changed the overall understanding o...
  • Evidence snippets:
  • Snippet 1 (score: 0.335) > : Transcriptome profiling is one of the most widely used approaches in the field of multiomics research. It plays a crucial role in the prognostic, diagnostic, and predictive treatment of cancer patients. Novel next-generation sequencing (NGS) technologies permit the identification of cancer biomarkers, gene signatures, and their abnormal expression, affecting oncogenic and molecular targets and novel biomarkers for cancer therapies. Multiomics studies have changed the overall understanding of cancer and opened a precise perspective for tumor diagnostics and therapy. The use of these approaches has strengthened our understanding of disease pathophysiology and classifications at the molecular level, including specific interference with drug mechanisms of action. Still, it has limited added value in the clinical setting. The omics data on precision medicine include the application of data from genes, transcripts, and proteins for diagnosis, monitoring of diseases, risk factor determination, counseling, and development of novel therapeutics. Bioinformatics applications have expanded statistics-based analysis toward deriving molecular pathways and process models for characterizing phenotypes and drug action mechanisms. In this review, we will discuss transcriptomics and interference analysis that allows the identification of predictive biomarkers at the molecular level to test drug response and analyze the molecular process interface of disease progression-relevant pathophysiology and mechanism of action to propose predictive biomarkers.

[13] Computational modelling of TNFα related pathways regulated by neuroinflammation, oxidative stress and insulin resistance in neurodegeneration

  • Authors: Hemalatha Sasidharakurup, Shyam Diwakar
  • Year: 2020
  • Venue: Applied Network Science
  • URL: https://www.semanticscholar.org/paper/aea95bfe3c4303f1361a8ea72828d2926ea0d03e
  • DOI: 10.1007/s41109-020-00307-w
  • Citations: 9
  • Summary: Simulations suggest insulin may be an important factor identifying neurodegeneration in AD and PD, through its action along with the neuroinflammation and oxidative stress.
  • Evidence snippets:
  • Snippet 1 (score: 0.335) > Modelling complex biological pathway networks including their cellular and molecular components, and interactions (Ji et al. 2017) can help connect critical factors statistically relevant as common signaling mechanisms or phentotypic functions to both disorders. Developing computational models can aid reproducing disease pathways and predicting dynamical behaviours essential for approprite protocol design and experimental testing and to map clinical symptoms to molecular processes going through cellular and circuit functions (Conradi et al. 2007;Bartocci and Lió 2016). Using biochemical systems theory (BST), sub-cellular reactions and biochemical pathways were modeled using ordinary differential equations (ODE) for reconstructing signalling dynamics in this study (Savageau et al. 1987). All biochemical reactions involved in disease-related signalling pathways were expressed mathematically using ODE and rate equations were computed using computational tools (Bartocci and Lió 2016). > The objective of this modeling exercise was to map major genes or proteins involved in disease mechanism, the reactions affected by the mutation of these genes and the difference in reactions when compared with healthy controls, action ofpotential drugs. In literature, BST models on oxidative stress and inflammation in insulin resistance were already available for PD condition (Braatz and Coleman 2015). These models explore some of the important pathways involved in PD and the treatment options. Most of the initial conditions for the model parameters were assigned as relative values rather than real data. With the need to model crosstalk and critical networks relevant to neurodegeneration identified by more recent studies, we have incorporated the crosstalk between insulin resistance, oxidative stress and neuroinflammation related to TNFα signalling in normal, AD and PD conditions (Fallahi-Sichani et al. 2011;Sasidharakurup et al. 2020;Su and Wu 2020). The parameteric values relating to biological states and initial conditions for this model were manually extracted from literature on disease models. In a previous study, we had modelled the role of TNFα mediated glutamate excitotoxicity and neuroinflammation (Sasidharakurup et al. 2020) and the variations in TNFα levels during both healthy and diseased conditions were analyzed.

[14] Targeting Hepatic Stellate Cells for the Prevention and Treatment of Liver Cirrhosis and Hepatocellular Carcinoma: Strategies and Clinical Translation

  • Authors: Hao Xiong, Jinsheng Guo
  • Year: 2025
  • Venue: Pharmaceuticals
  • URL: https://www.semanticscholar.org/paper/76e92127053136900f7e3f10e2c9278251ced5d2
  • DOI: 10.3390/ph18040507
  • PMID: 40283943
  • PMCID: 12030350
  • Citations: 8
  • Summary: HSC-targeted approaches using specific surface markers and receptors may enable the selective delivery of drugs, oligonucleotides, and therapeutic peptides that exert optimized anti-fibrotic and anti-HCC effects.
  • Evidence snippets:
  • Snippet 1 (score: 0.334) > Significant progress has been made in elucidating the cellular and molecular mechanisms of liver fibrosis; however, only a few findings have been successfully translated into clinical applications. Firstly, the high cost of drug development and target validation necessitates prolonged timelines and substantial financial investment. Secondly, as regulatory requirements become more stringent, there is an increasing demand for drugs with well-defined clinical efficacy and safety profiles. Moreover, the efficacy observed in animal models often fails to fully translate to clinical settings due to differences in pharmacokinetics, extracellular matrix (ECM) cross-linking, and disease pathophysiology. Despite advancements in anti-fibrotic drug development, accurately identifying ideal noninvasive biomarkers for fibrotic activity and establishing consensus on optimal clinical endpoints remain significant challenges [113,114]. > Currently, addressing the underlying cause remains the only proven strategy to halt or reverse liver fibrosis progression, while the development of effective anti-fibrotic therapies continues to pose a major challenge in liver disease management. Over the past few decades, substantial progress has been made in elucidating the cellular and molecular mechanisms underlying liver fibrosis. Liver fibrosis is a complex pathological change involving multiple cells, factors, and pathways, and the study of the cellular and molecular mechanisms of its occurrence and development provides an important theoretical basis and therapeutic target for clinical drug development. It is anticipated that improved animal models and well-designed clinical trials will facilitate the successful translation of anti-fibrotic research into effective clinical treatments in the near future.

[15] Massive changes in gene expression and their cause(s) can be a unifying principle in the pathobiology of Alzheimer's disease

  • Authors: P. Coleman, Elaine Delvaux, J. H. Kordower, Ashley Boehringer, Carol J. Huseby
  • Year: 2025
  • Venue: Alzheimer's & Dementia
  • URL: https://www.semanticscholar.org/paper/81c804d9a09df3de462ba1a9c3a1b28c98b021cd
  • DOI: 10.1002/alz.14555
  • PMID: 39912452
  • PMCID: 11851168
  • Citations: 5
  • Summary: Evidence for a unifying model based on sequestrations in stress granules and alteration of nucleocytoplasmic transport in AD is reviewed, with a focus on sequestrations in stress granules and alteration of nucleocytoplasmic transport.
  • Evidence snippets:
  • Snippet 1 (score: 0.333) > The Alzheimer's disease (AD) field has long been fragmented. Over the decades, there have been a series of hypotheses of biological mechanisms in AD including cholinergic (e.g., Davies & Maloney), 1 inflammation (e.g., Akiyama et al.), 2 viral, 3 mitochondrial, 4 protein processing, 5 vascular, 6 tau, 7 and amyloid 8 hypotheses, among others. > None of these hypotheses have led to halting or reversing disease, and there are a number of possible explanations for these failures, including intervention coming too late in disease progression. However, the failures do not have to mean that these hypotheses are wrong. They all deal with real facts in the biology of AD but are limited by each addressing only a portion of the biology of AD. We argue that the total biological complexity of AD is represented in the large number of changes in gene expression that have been described in many studies and represent > 90% of known Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. The comprehensive text-mining study of Morgan et al. 9 reported that pathways altered in AD are related to synapses, cell death, inflammation, phagosome, virus infection, metabolic pathways, calcium signaling, transcription, lysosome, long-term potentiation (LTP), protein processing in endoplasmic reticulum (ER), cell cycle, actin, mammalian target of rapamycin pathway, ribosome, Ras pathway, interleukin 17 pathway, RNA polymerase RNA transport, Hippo signaling pathway, and more (see Table S9 in Morgan et al. 9 ). This raises the question of what mechanism(s) may be responsible for the thousand plus changes in gene expression in AD. > In addition to these many gene expression changes in AD, a host of risk factors have also been described for the AD clinical phenotype, including genetic, environmental, and lifestyle factors. How can we link the inputs of risk factors with the outputs of gene expression changes, AD cellular phenotype, and clinical disease? What cellular/molecular mechanism(s) may play a role in the coordinated change in expression of such large numbers of genes in AD?

[16] Microglia Activation in the Brain as Inflammatory Biomarker of Alzheimer’s Disease Neuropathology and Clinical Dementia

  • Authors: Z. Xiang, V. Haroutunian, L. Ho, Dushant P. Purohit, G. Pasinetti
  • Year: 2005
  • Venue: Disease Markers
  • URL: https://www.semanticscholar.org/paper/c67d600b340d2f12afa77ea72927ad5b491a0fca
  • DOI: 10.1155/2006/276239
  • PMID: 16410654
  • PMCID: 3850819
  • Citations: 105
  • Influential citations: 3
  • Summary: The results suggest that microglia activation increases with the progression of AD, with the increase varying depending on the involved brain region.
  • Evidence snippets:
  • Snippet 1 (score: 0.332) > In recent years, a large number of epidemiological studies have addressed the possible protective effect of anti-inflammatory drug use with regard to AD [3]. It is still uncertain however, whether inflammatory mechanisms actually cause damage in AD, or are merely present to remove the debris associated with neurodegenerative events. On a molecular level it is apparent that an inflammatory response accompanies the neu-ropathologic features of AD [1,18] though clinical features of inflammation are absent. The complement system appears to be active in the AD brain [16], with generation of the lytic membrane attack complex [24], and presumably with the release of anaphylatoxins. Upregulation of cyclooxygenase (COX)-2 in neurons as a function of the clinical progression of the AD dementia [9] suggests that inflammatory lipids may also be involved in the pathogenesis of the disease [17]. > As the major cellular mediators of inflammation, microglia have the characteristics of antigen-presenting tissue macrophages, including Human Leukocyte Antigen (HLA)-DR surface markers [11]. HLA-DR expression is found in microglia assuming either a ramified (resting state) or an amoeboid (reactive or activated state) morphology. Microglia may synthesize and secrete β-amyloid (Aβ) [26], as well as produce cytokines [25], nitric oxide and superoxide free radicals [4,5] that may aggravate or promote neurodegeneration. Activated microglia increase in AD patients and also in elderly non-AD controls [11]. Activated microglia and astrocytes have been found in abundance near neuritic plaques (NP) and neurofibrillary tangles (NT) in definitive AD cases [11,21,23]. However, it is unclear how microglia activation evolves in relation to the clinical progression of AD pathology or cognitive status. > In our previous study, we found that up-regulation of neuronal COX-2 protein appeared very early in the clinical progression of AD and preceded the onset of the induction of cytokine gene expression [9,10].

[17] Solving the Evidence Interpretability Crisis in Health Technology Assessment: A Role for Mechanistic Models?

  • Authors: E. Courcelles, J. Boissel, J. Massol, I. Klingmann, R. Kahoul et al.
  • Year: 2022
  • Venue: Frontiers in Medical Technology
  • URL: https://www.semanticscholar.org/paper/877d5b1b75599745f704a9c8371f74601ff17e2f
  • DOI: 10.3389/fmedt.2022.810315
  • PMID: 35281671
  • PMCID: 8907708
  • Citations: 6
  • Summary: Light is shed on different stakeholder's contributions and needs in the appraisal phase and how mechanistic modeling strategies and reporting can contribute to this effort to implement mechanistic models central in the evidence generation, synthesis, and appraisal of HTA so that the totality of mechanistic and clinical evidence can be leveraged by all relevant stakeholders.
  • Evidence snippets:
  • Snippet 1 (score: 0.332) > A second limitation in HTA is the fact that currently population (and sometimes stratified) medicine is pursued during clinical Uncertainty not completely addressed in competent authority assessment report Example use of MIDD relevant to address uncertainty potentially also during HTA What is the optimal dosage in the clinical context? > Physiologically based pharmacokinetic models can investigate dosing-regimens relevant for regulatory review and product labels (9) and can also mimic real-life adherence to prescribed treatment regimens (see also below) or pharmacology-relevant characteristics of special populations as well as drug-drug interactions. > What is the duration of the effectiveness, especially with chronic use of a treatment? > Mechanistic models can predict the long-term disease progression by extrapolation of shorter-term findings under the constraints of how the components of the system function (and these constraints convey biological plausibility by design). An example is the use of a mechanism-based disease progression model for comparison of long-term effects of pioglitazone, metformin, and gliclazide on disease processes underlying Type 2 Diabetes Mellitus (10). Another example is prediction of long-term outcomes by short-term marker data as demonstrated by a semi-mechanistic approach in context of osteoporosis treatment (11). > What is the efficacy for relevant clinical outcomes? > Mechanistic models combined with pharmacometric approaches can translate findings for one outcome to a range of other outcomes. An example of survival modeling on the back of a mechanistic description is the modeling framework for CD19-Specific CAR-T cell immunotherapy using a quantitative systems pharmacology model (12). > What is the size of the clinical effect dependent on patient characteristics and extrinsic factors? > Data-driven modeling techniques can capture correlation within clinical data. Describing the clinical effect of a drug can also be based on mechanistic considerations. Such models either (a) link disease phenotypes to increasingly granular mathematical representations of pathophysiologic processes (top-down approach) or (b) derive functional, computable cellular networks from the molecular building blocks of genes and proteins to elucidate the impact of pathologic or therapeutic alterations on network operating states and hence clinical phenotype (bottom-up) [

[18] Homocysteine thiolactone and N-homocysteinylated protein induce pro-atherogenic changes in gene expression in human vascular endothelial cells

  • Authors: D. Gurda, L. Handschuh, Weronika Kotkowiak, H. Jakubowski
  • Year: 2015
  • Venue: Amino Acids
  • URL: https://www.semanticscholar.org/paper/0e9ac31119ab67e72fdaa6e9cc442fa7ed2f4642
  • DOI: 10.1007/s00726-015-1956-7
  • PMID: 25802182
  • PMCID: 4458266
  • Citations: 93
  • Influential citations: 3
  • Summary: It is found that each Hcy metabolite uniquely modulates gene expression in pathways important for vascular homeostasis and identify new genes and pathways that are linked to HHcy-induced endothelial dysfunction and vascular disease.
  • Evidence snippets:
  • Snippet 1 (score: 0.331) > lead to the accumulation of Hcy and its metabolites in the blood-hyperhomocysteinemia (HHcy)-which is an independent risk factor for cardiovascular disease (CVD) and causes endothelial dysfunction, a hallmark of atherosclerosis (Dayal and Lentz 2008). However, molecular mechanisms underlying the pathophysiology of HHcy are not fully understood (Jakubowski 2011(Jakubowski , 2013;;Perla-Kajan et al. 2007). One hypothesis states that metabolic conversion of Hcy to Hcythiolactone initiates a pathway that leads to pathologies associated with HHcy (Jakubowski 1997a(Jakubowski , 1999(Jakubowski , 2007)). Hcy-thiolactone is chemically reactive and modifies ε-amino groups of protein lysine residues, which generates immunogenic and toxic N-homocysteinylated protein (N-Hcy-protein) (Jakubowski 2008(Jakubowski , 2013;;Jakubowski et al. 2000). > In humans and mice, HHcy leads to the accumulation of Hcy-thiolactone and N-Hcy-protein, in addition to Hcy (Chwatko et al. 2007;Jakubowski et al. 2008Jakubowski et al. , 2009)). We and other investigators have shown that HHcy induces changes in gene expression in mouse models that are associated with atherothrombotic disease (Devlin et al. 2005;DiBello et al. 2010;Ingrosso et al. 2003;Kim et al. 2011;Pogribny et al. 2008;Sharma et al. 2006;Suszynska-Zajczyk et al. 2014a, b, c, d). However, it is not known what mechanism(s) are involved and which metabolite-Hcy itself, Hcy-thiolactone, or N-Hcy-protein-is responsible for changes in gene expression. > The key to understanding mechanisms by which HHcy disrupts normal cellular function and ultimately causes disease is to identify genes whose expression is affected by individual Hcy metabolites.

[19] Differential metabolic markers associated with primary open-angle glaucoma and cataract in human aqueous humor

  • Authors: C. Pan, Chaofu Ke, Qin Chen, Yijin Tao, Xu Zha et al.
  • Year: 2020
  • Venue: BMC Ophthalmology
  • URL: https://www.semanticscholar.org/paper/a22a466f72ee8f8a5808f51c7000ff38b8b60b04
  • DOI: 10.1186/s12886-020-01452-7
  • PMID: 32375707
  • PMCID: 7203853
  • Citations: 26
  • Influential citations: 1
  • Summary: This study identified valuable metabolic biomarkers and pathways that may facilitate an improved understanding of the POAG pathogenesis and hold translational value in the development of new therapeutic measures for POAG.
  • Evidence snippets:
  • Snippet 1 (score: 0.330) > Primary open-angle glaucoma (POAG) is the most common subtype of glaucoma and the major cause of irreversible blindness throughout the world [1]. Although numerous studies have identified several important ocular risk factors for POAG such as increased intraocular pressure (IOP) [2,3], myopic refractive errors [4], larger optic disc size [5,6] and thinner central corneal thickness [7,8], these findings are limited in understanding the pathophysiology of POAG. Further knowledge regarding the pathophysiology might help to create new drug development research lines and expand current therapeutic targets for POAG. In current clinical practice, the treatment strategy of POAG mainly relies on IOP-lowering medications or surgeries. Although increased IOP is widely accepted to be the primary predictor for POAG, glaucomatous neuropathy is still observed in some patients with normal or even lower-than-normal IOPs, suggesting that other mechanisms exist in the pathophysiology of POAG. > Metabolomics is a widely used technology to assess biomarkers for diseases and provide molecular information regarding disease phenotype since metabolites are the ultimate product of gene, mRNA and protein activities [9]. Variations in the metabolome represent the interplay of genetic and environmental factors and are in relation to disease states, which may shed some lights in mechanism and pathophysiology of the disease [10]. With regard to eye diseases, metabolomics has been successfully used in identifying the metabolic signatures of diabetic retinopathy [11]. However, there were less studies focusing on POAG, especially in human participants. A previous analysis comparing plasma metabolic signatures as measured by mass spectrometry observed significant differences in some specific metabolic processes such as palmitoylcarnitine, sphingolipids, vitamin Drelated compounds, and steroid precursors between POAG patients and healthy controls [12]. These differences observed in metabolome might be linked to mitochondrial dysfunction and energy metabolism changes [12].

[20] LifeTime and improving European healthcare through cell-based interceptive medicine

  • Authors: N. Rajewsky, G. Almouzni, S. Gorski, S. Aerts, I. Amit et al.
  • Year: 2020
  • Venue: Nature
  • URL: https://www.semanticscholar.org/paper/d626a4acb560c1ef16ea394cb4dccf277882d119
  • DOI: 10.1038/s41586-020-2715-9
  • PMID: 32894860
  • PMCID: 7656507
  • Citations: 138
  • Influential citations: 2
  • Summary: The LifeTime initiative is an ambitious, multidisciplinary programme that aims to improve healthcare by tracking individual human cells during disease processes and responses to treatment in order to develop and implement cell-based interceptive medicine in Europe over the next decade.
  • Evidence snippets:
  • Snippet 1 (score: 0.328) > , a major challenge is a lack of understanding of the early events in disease onset to enable the development of disease-modifying therapies. The lack of access to longitudinal samples from patients necessitates the establishment of cohorts of patient-derived disease models to understand the cellular heterogeneity associated with disease. The discovery of pathways and biomarkers that will allow the stratification of patients on the basis of the cellular mechanisms that drive a disease will make it possible to design new clinical trials to reevaluate drugs that were previously tested without such stratification, and to broaden the drug target portfolio. > As seen during the coronavirus disease 2019 (COVID-19) pandemic, it is important to be able to understand infection mechanisms and the host response in order to rapidly identify the most likely effective treatment for an infection. At the same time, the continuous rise of antimicrobial resistance requires the discovery of new therapeutic strategies. A key medical challenge for infectious diseases is to understand the cellular response to infections and to develop precision, immune-based therapeutic strategies to combat infections. > Chronic inflammatory diseases impose a high burden owing to their long-term debilitating consequences, which result from the structural destruction of affected organs or tissues. Current therapies treat the symptoms but do not cure or fully control the chronic inflammatory pathophysiology. While different targeted therapies exist, they are expensive and their success is limited by high rates of non-response to treatment. Consequently, there is an urgent need to explore and understand how cellular heterogeneity contributes to the pathology of inflammatory diseases 61 and how this relates to the predicted course of disease and the response of a patient to one of the numerous available therapies. > Many cardiovascular and metabolic diseases lack effective therapies owing to a lack of knowledge of their underlying causes and the link between abnormal cardiac cell structure or function and pathophysiology. The identified medical priority is to understand the cellular and molecular mechanisms involved, in order to enable early diagnosis and the design of new mechanism-based therapies for precise clinical treatment. > The LifeTime disease roadmaps can be divided broadly into three phases 7 : first, immediate research into the identified medical challenges using established, scaled single-cell technologies, computational tools and disease models; second, the development of new technologies that are required

Notes

  • This provider combines search_papers_by_relevance with snippet_search.
  • No synthesis or second-stage model call is performed.
{ }

Source YAML

click to show
name: pseudotumor cerebri
creation_date: '2026-04-13T04:00:00Z'
updated_date: '2026-04-13T23:58:00Z'
description: >-
  Pseudotumor cerebri, now commonly framed as idiopathic intracranial
  hypertension (IIH) in its primary form, is a syndrome of elevated
  intracranial pressure without mass lesion, hydrocephalus, or abnormal CSF
  composition. The current mechanistic model emphasizes dysregulated CSF
  dynamics and elevated venous sinus pressure on a metabolic background strongly
  associated with obesity. Clinically, patients present with headache,
  papilledema, visual dysfunction, and pulsatile tinnitus, with risk of
  permanent visual loss if untreated.
category: Complex
parents:
- disease
- intracranial hypertension
disease_term:
  preferred_term: pseudotumor cerebri
  term:
    id: MONDO:0009468
    label: pseudotumor cerebri
synonyms:
- idiopathic intracranial hypertension
- IIH
pathophysiology:
- name: Dysregulated cerebrospinal fluid dynamics
  description: >-
    The central pathophysiologic problem in IIH is dysregulation of CSF
    dynamics, leading to persistently elevated intracranial pressure in the
    absence of a mass lesion.
  cell_types:
  - preferred_term: choroid plexus epithelial cell
    term:
      id: CL:0000706
      label: choroid plexus epithelial cell
  biological_processes:
  - preferred_term: cerebrospinal fluid secretion
    modifier: ABNORMAL
    term:
      id: GO:0033326
      label: cerebrospinal fluid secretion
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The pathophysiology involves dysregulation of cerebrospinal fluid (CSF) dynamics and venous sinus pressure
    explanation: This directly supports dysregulated CSF dynamics as the core mechanism.
  downstream:
  - target: Elevated intracranial pressure
    description: CSF dysregulation produces sustained elevation of intracranial pressure.
- name: Elevated intracranial pressure
  description: >-
    Persistently elevated intracranial pressure causes the characteristic
    neuro-ophthalmologic and headache syndrome of pseudotumor cerebri.
  evidence:
  - reference: PMID:38575259
    reference_title: The Pseudotumor Cerebri Syndrome.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      Pseudotumor cerebri syndrome is a syndrome of increased cerebrospinal fluid pressure without ventriculomegaly, mass lesion, or meningeal abnormality.
    explanation: This directly supports elevated CSF pressure as the defining proximal abnormality.
  downstream:
  - target: Papilledema and visual injury
    description: Elevated pressure injures the optic nerve head and threatens vision.
  - target: Headache syndrome
    description: Elevated pressure produces the characteristic headache syndrome.
- name: Metabolic risk background
  description: >-
    IIH strongly favors obese women of reproductive age, and metabolic and
    hormonal factors are thought to amplify CSF and venous-pressure
    dysregulation.
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      IIH demonstrates a strong predilection towards obese women of reproductive age
    explanation: This supports the major metabolic-epidemiologic background on which IIH develops.
  downstream:
  - target: Dysregulated cerebrospinal fluid dynamics
    description: Metabolic and hormonal factors contribute to CSF and venous-pressure abnormalities.
- name: Papilledema and visual injury
  description: >-
    Elevated intracranial pressure leads to papilledema and threatens permanent
    visual loss if not recognized and treated.
  evidence:
  - reference: PMID:38575259
    reference_title: The Pseudotumor Cerebri Syndrome.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      Permanent visual loss occurs if undetected or untreated
    explanation: This directly supports the optic-nerve/vision branch of the disease mechanism.
- name: Headache syndrome
  description: >-
    Headache is the predominant symptomatic morbidity of pseudotumor cerebri and
    reflects the elevated-pressure state.
  evidence:
  - reference: PMID:35103000
    reference_title: Idiopathic Intracranial Hypertension - Challenges and Pearls.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      headache is the predominant morbidity in over 90%.
    explanation: This directly supports headache as the dominant symptomatic output of the pressure syndrome.
phenotypes:
- name: Headache
  category: Neurologic
  description: >-
    Headache is the dominant symptomatic burden in pseudotumor cerebri.
  phenotype_term:
    preferred_term: Headache
    term:
      id: HP:0002315
      label: Headache
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The primary symptoms include headache, vision loss, and pulsatile tinnitus
    explanation: This directly supports headache as a primary symptom.
- name: Papilledema
  category: Ophthalmic
  diagnostic: true
  description: >-
    Papilledema is the hallmark neuro-ophthalmologic sign of raised
    intracranial pressure in IIH.
  phenotype_term:
    preferred_term: Papilledema
    term:
      id: HP:0001085
      label: Papilledema
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure, manifested by papilledema
    explanation: This directly supports papilledema as a defining sign.
- name: Visual loss
  category: Ophthalmic
  frequency: FREQUENT
  description: >-
    Visual dysfunction and permanent visual loss can occur if elevated
    intracranial pressure is not controlled.
  phenotype_term:
    preferred_term: Visual loss
    term:
      id: HP:0000572
      label: Visual loss
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The primary symptoms include headache, vision loss, and pulsatile tinnitus
    explanation: This directly supports visual loss as a primary symptom.
  - reference: clinicaltrials:NCT01003639
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Because of pressure on the optic nerve (papilledema), 86% have some degree of permanent visual loss and 10% develop severe visual loss
    explanation: This quantitative trial summary supports visual loss as a frequent phenotype in pseudotumor cerebri.
- name: Pulsatile tinnitus
  category: Otolaryngologic
  description: >-
    Pulsatile tinnitus is a common pressure-related symptom in pseudotumor
    cerebri.
  phenotype_term:
    preferred_term: Pulsatile tinnitus
    term:
      id: HP:0008629
      label: Pulsatile tinnitus
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The primary symptoms include headache, vision loss, and pulsatile tinnitus
    explanation: This directly supports pulsatile tinnitus as a primary symptom.
treatments:
- name: Acetazolamide
  treatment_term:
    preferred_term: pharmacotherapy
    term:
      id: MAXO:0000058
      label: pharmacotherapy
    therapeutic_agent:
    - preferred_term: acetazolamide
      term:
        id: CHEBI:27690
        label: acetazolamide
  description: >-
    Acetazolamide is the best-studied medical therapy and improves visual
    outcomes when combined with a weight-reduction program in patients with mild
    visual loss.
  target_phenotypes:
  - preferred_term: Papilledema
    term:
      id: HP:0001085
      label: Papilledema
  - preferred_term: Visual loss
    term:
      id: HP:0000572
      label: Visual loss
  evidence:
  - reference: PMID:24756514
    reference_title: "Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In patients with IIH and mild visual loss, the use of acetazolamide with a low-sodium weight-reduction diet compared with diet alone resulted in modest improvement in visual field function.
    explanation: This randomized trial directly supports acetazolamide as disease-relevant therapy.
- name: Weight-reduction intervention
  treatment_term:
    preferred_term: dietary intervention
    term:
      id: MAXO:0000088
      label: dietary intervention
  description: >-
    Weight reduction is a core disease-directed intervention in overweight
    patients with IIH.
  target_phenotypes:
  - preferred_term: Headache
    term:
      id: HP:0002315
      label: Headache
  - preferred_term: Papilledema
    term:
      id: HP:0001085
      label: Papilledema
  evidence:
  - reference: PMID:34929642
    reference_title: "Idiopathic intracranial hypertension: Pathophysiology, diagnosis and management."
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The Idiopathic Intracranial Hypertension Treatment Trial, the first of its kind randomized controlled trial on IIH, provides class I evidence for treatment with weight loss and acetazolamide.
    explanation: This directly supports weight loss as a disease-directed intervention.
diagnosis:
- name: Magnetic resonance imaging
  diagnosis_term:
    preferred_term: magnetic resonance imaging procedure
    term:
      id: MAXO:0000424
      label: magnetic resonance imaging procedure
  description: >-
    Neuroimaging is required to exclude mass lesion and other structural causes
    of intracranial hypertension.
  results: Normal brain imaging without mass lesion supports IIH after exclusion of secondary causes.
  evidence:
  - reference: PMID:12455560
    reference_title: Diagnostic criteria for idiopathic intracranial hypertension.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      Since then, new developments, including advances in neuroimaging technology and recognition of additional secondary causes of intracranial hypertension, have further enhanced the ability to diagnose conditions that may mimic IIH.
    explanation: This supports neuroimaging as a required diagnostic step.
- name: Lumbar puncture with opening pressure measurement
  description: >-
    Diagnostic lumbar puncture is used to document elevated opening pressure and
    normal CSF composition.
  results: Elevated opening pressure with normal CSF composition supports the diagnosis.
  evidence:
  - reference: PMID:12455560
    reference_title: Diagnostic criteria for idiopathic intracranial hypertension.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The syndrome of increased intracranial pressure without hydrocephalus or mass lesion and with normal CSF composition
    explanation: This directly supports lumbar puncture-based confirmation of pressure elevation with normal CSF composition.
differential_diagnoses:
- name: Cerebral sinovenous thrombosis
  disease_term:
    preferred_term: cerebral sinovenous thrombosis
    term:
      id: MONDO:0017993
      label: cerebral sinovenous thrombosis
  description: >-
    Venous sinus thrombosis can mimic IIH with papilledema and raised
    intracranial pressure and must be excluded on imaging.
  evidence:
  - reference: PMID:39525793
    reference_title: "Idiopathic intracranial hypertension following childbirth: a case report and management strategies."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Common causes of headaches during puerperium include pre-eclampsia, subarachnoid hemorrhage, cerebral venous thrombosis, meningitis, brain tumors, cerebrovascular diseases, and posterior reversible encephalopathy syndrome.
    explanation: This directly identifies cerebral venous thrombosis as an important competing diagnosis in patients presenting with pseudotumor-cerebri-like headache and visual symptoms.
- name: Brain neoplasm
  disease_term:
    preferred_term: brain neoplasm
    term:
      id: MONDO:0021211
      label: brain neoplasm
  description: >-
    Intracranial mass lesions must be excluded before the diagnosis of
    pseudotumor cerebri is made.
  evidence:
  - reference: PMID:12455560
    reference_title: Diagnostic criteria for idiopathic intracranial hypertension.
    supports: SUPPORT
    evidence_source: OTHER
    snippet: >-
      The syndrome of increased intracranial pressure without hydrocephalus or mass lesion and with normal CSF composition, previously referred to as pseudotumor cerebri, is a diagnosis of exclusion now termed idiopathic intracranial hypertension (IIH).
    explanation: This directly supports exclusion of mass lesions such as brain neoplasms when diagnosing pseudotumor cerebri.
clinical_trials:
- name: NCT01003639
  phase: PHASE_III
  status: COMPLETED
  description: >-
    Randomized placebo-controlled IIHTT trial testing acetazolamide plus
    low-sodium weight-reduction diet in patients with mild visual loss.
  target_phenotypes:
  - preferred_term: Visual loss
    term:
      id: HP:0000572
      label: Visual loss
  - preferred_term: Papilledema
    term:
      id: HP:0001085
      label: Papilledema
  evidence:
  - reference: clinicaltrials:NCT01003639
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      This trial will study subjects who have mild visual loss from IIH to (1) establish convincing, evidence-based treatment strategies for IIH to restore and protect vision, (2) follow subjects up to 4 years to observe the long-term treatment outcomes and (3) determine the cause of IIH.
    explanation: The registered IIHTT trial directly targeted visual outcomes in IIH.
datasets:
- accession: PMID:24756514
  title: "Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial."
  description: >-
    Multicenter randomized controlled trial dataset capturing visual fields,
    papilledema grading, weight change, and headache-related outcomes in IIH.
  organism:
    preferred_term: Homo sapiens
    term:
      id: NCBITaxon:9606
      label: Homo sapiens
  sample_count: 165
  conditions:
  - idiopathic intracranial hypertension
  - mild visual loss
  publication: PMID:24756514
  evidence:
  - reference: PMID:24756514
    reference_title: "Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Multicenter, randomized, double-masked, placebo-controlled study of acetazolamide in 165 participants with IIH and mild visual loss
    explanation: This supports the study as a reusable human interventional dataset for IIH.